Rural Health
Resources by Topic: Medicare
Accountable Health Communities Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's Accountable Health Communities Model, which tested whether systematically identifying and addressing the health-related social needs of Medicare and Medicaid beneficiaries through screening, referral, and community navigation services would impact healthcare costs and reduce healthcare utilization. Aimed to link beneficiaries with community services that may address their health-related social needs.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's Accountable Health Communities Model, which tested whether systematically identifying and addressing the health-related social needs of Medicare and Medicaid beneficiaries through screening, referral, and community navigation services would impact healthcare costs and reduce healthcare utilization. Aimed to link beneficiaries with community services that may address their health-related social needs.
Sponsoring organization: Centers for Medicare and Medicaid Services
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ACO Primary Care Flex Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Primary Care Flex Model, which will test how prospective payments and increased funding for primary care in accountable care organizations (ACOs) impact health outcomes, quality, and costs of care. Aims to increase the number of low-revenue ACOs participating in the Medicare Shared Savings Program (SSP), including ACOs serving rural and underserved populations.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Primary Care Flex Model, which will test how prospective payments and increased funding for primary care in accountable care organizations (ACOs) impact health outcomes, quality, and costs of care. Aims to increase the number of low-revenue ACOs participating in the Medicare Shared Savings Program (SSP), including ACOs serving rural and underserved populations.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospital Price Transparency
Offers resources for healthcare providers and consumers regarding hospital price transparency regulations and policies. Includes links to a GitHub repository of resources for templates and technical instructions and tools to support hospitals in meeting accessibility and machine-readable file requirements.
Additional links: GitHub Repository
Sponsoring organization: Centers for Medicare and Medicaid Services
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Offers resources for healthcare providers and consumers regarding hospital price transparency regulations and policies. Includes links to a GitHub repository of resources for templates and technical instructions and tools to support hospitals in meeting accessibility and machine-readable file requirements.
Additional links: GitHub Repository
Sponsoring organization: Centers for Medicare and Medicaid Services
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NARHC REF RHC Data Portal
Interactive tool providing data on the Healthcare Common Procedure Coding System (HCPCS) codes and Current Procedural Terminology (CPT) codes used by Rural Health Clinics (RHCs) for services provided to Medicare beneficiaries. Uses a statistically adjusted sample of health care claims data and carrier file claims from 2019-2021. Data are searchable by claim year, code, and percentage and frequency of use.
Sponsoring organizations: Catherine Cutler Institute, National Association of Rural Health Clinics, National Association of Rural Health Clinics Research and Education Foundation
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Interactive tool providing data on the Healthcare Common Procedure Coding System (HCPCS) codes and Current Procedural Terminology (CPT) codes used by Rural Health Clinics (RHCs) for services provided to Medicare beneficiaries. Uses a statistically adjusted sample of health care claims data and carrier file claims from 2019-2021. Data are searchable by claim year, code, and percentage and frequency of use.
Sponsoring organizations: Catherine Cutler Institute, National Association of Rural Health Clinics, National Association of Rural Health Clinics Research and Education Foundation
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Medicare Learning Network: Chronic Care Management Services
Provides general information about payable chronic care management service elements, practitioners able to bill for CCM services, patient eligibility, service codes, concurrent billing, and Medicare Physician Fee Schedule (PFS) billing requirements. Includes information on Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) billing for CCM services.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides general information about payable chronic care management service elements, practitioners able to bill for CCM services, patient eligibility, service codes, concurrent billing, and Medicare Physician Fee Schedule (PFS) billing requirements. Includes information on Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) billing for CCM services.
Sponsoring organization: Centers for Medicare and Medicaid Services
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States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, a voluntary state total cost of care model that will test state accountability for controlling overall growth in health expenditures while increasing investment in primary care and improving population health outcomes.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, a voluntary state total cost of care model that will test state accountability for controlling overall growth in health expenditures while increasing investment in primary care and improving population health outcomes.
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Operations Manual Appendix B - Guidance for Surveyors: Home Health Agencies
Presents interpretive guidelines clarifying statutory and regulatory requirements for home health agencies.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents interpretive guidelines clarifying statutory and regulatory requirements for home health agencies.
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Operations Manual Appendix M - Guidance for Surveyors: Hospice
Details the hospice survey process and presents interpretive guidelines clarifying statutory and regulatory requirements.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Details the hospice survey process and presents interpretive guidelines clarifying statutory and regulatory requirements.
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Operations Manual Appendix G - Guidance for Surveyors: Rural Health Clinics (RHCs)
Provides details and interpretive guidelines clarifying the Rural Health Clinic (RHC) survey and certification processes.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details and interpretive guidelines clarifying the Rural Health Clinic (RHC) survey and certification processes.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Shared Savings Program
Provides an overview of the Medicare Shared Savings Program. Offers links to program resources, including application information, program data, and program statutes and regulations.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Medicare Shared Savings Program. Offers links to program resources, including application information, program data, and program statutes and regulations.
Sponsoring organization: Centers for Medicare and Medicaid Services
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